时辰化给予左旋氨氯地平和替米沙坦对老年晨峰型高血压患者血压昼夜节律的影响被引量：9

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摘要目的分析评价时辰化给予左旋氨氯地平和替米沙坦对老年晨峰型高血压患者血压昼夜节律的影响及逆转左心室肥厚、减小QT离散度的作用。方法将入选的老年晨峰型高血压患者随机分为A、B组,两组均停用降压药物2周,A组清晨顿服左旋氨氯地平2.5mg.d-1,替米沙坦80mg.d-1;B组清晨服用替米沙坦80mg,晚间服用左旋氨氯地平2.5mg。采用动态血压监测仪观察清晨顿服及早、晚分服联合使用左旋氨氯地平和替米沙坦对24h动态血压的影响,并观察逆转左心室肥厚及减少QT离散度(QTd)的作用。结果A、B两组用药后24h各时点收缩压及舒张压均低于用药前。B组夜间平均收缩压、晨峰血压升高程度、清晨收缩压、清晨舒张压较A组低(P<0.01或P<0.05)。治疗24周后B组的舒张期室间隔厚度(LVST)、舒张期左心室后壁厚度(LPWT)、舒张期左心室内径(LVDd)及QTd、校正的QT离散度(QTcd)均较A组减小(P<0.05)。结论老年晨峰型高血压患者时辰化联合使用左旋氨氯地平和替米沙坦更能改善血压昼夜节律,抑制清晨血压过度升高,在逆转左心室肥厚、减小QTd,保护心脏靶器官方面作用更显著。

作者向兰汀姚汉金刘明瑜

机构地区武汉市青山区第一医院心内科

出处《医药导报》 CAS 2009年第1期72-74,共3页 Herald of Medicine

关键词左旋氨氯地平替米沙坦血压晨峰左心室肥厚 Q—T离散度

分类号 R972.4 [医药卫生—药品] R544.1 [医药卫生—心血管疾病]

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1KARIO K, PICKERING T G, UMADA Y, et al. Morning surge in blood pressure as a preditor of silent and clinical cerebrovascular disease in elderly hypertensive: a prospective study [ J ]. Circulation, 2003,107 (10) : 1401 - 1406.
2GOSSE P, LASSERRE R, MINIFIE C,et al. Blood pressure surge on rising [ J]. Hypertension ,2004,22(6) : 1113 - 1118.
3KANEDA R, KARIOK, HOSHIDE S, et al. Morning blood pressure hyper-reactivity is an independent predictor for hypertensive cardiac hypertrophy in a community-dwelling population. [ J ]. Am Hypertens, 2003,18(12) : 1528 - 1533.
4MURATA T, TAKAHASHI T, OMORI M, et al. Aossociation of abnormal diurnal blood pressure variation with the devetopment of silent cerebral infarction in patients with late-life-onset depression [J]. Gen Hosp Psychiatry,2003,25 (4) :298 -300.
5BJORLDUND K, LIND L, ANDREN B, et al. The majority of nondipping men do not have inereased cardiovascular risle:a population- based study[J]. J Hypertens ,2002,20(8) : 1501 - 1506.
6KARIO K, PICKERING T G, HOSHIDE S, et al. Morning blood pressure surge and hypertensive cerebrovascular disease .role of the alpha adrenergic sympathetic nervous system [ J ]. Am Hypertens ,2004, 17(8) :668 -675.
7孙宁玲,喜杨,荆珊,卢熙宁.原发性高血压患者凌晨血压增高与年龄、性别的相关性研究[J].中国循环杂志,2006,21(2):103-105. 被引量：56
8KARIO K. Moring surge and variability in blood pressure target [ J ]. Hypertension ,2005,45 (4) :485 - 486.

二级参考文献10

1刘力生.2004年中国高血压防治指南(实用本)[J].中华心血管病杂志,2004,32(12):1060-1064. 被引量：2611
2Muller JE.Circadian variation in cardiovascular events.Am J Hypertens,1999,12 (Suppl):35S-42S.
3White WB.Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate.Blood Press Monit,2001,6:63-72.
4Kario K,Pickering TG,Hoshide S,et al.Morning blood pressure surge and hypertensive cerebrovascular disease.Role of the alpha adrenergicsympathetic nervous system.AM J Hypertens,2004,17:668-675.
5Eguchi K,Kario K,Shimada K.Comparision of candesartan with lisinopril on ambulatory blood pressure and morning surge in patients with systemic hypertension.Am J Cardiol,2003,92:621-624.
6Gosse P,Lasserre R,Minifie C,et al.Blood pressure surge on rising.J Hypertens.2004,22(6):1113-1118.
7Safar ME,Smulyan H.Hypertension in women.Am J Hypertens.2004,17(1):82-87.
8Sevre K,Lefrandt JD,Nordby G,et al.Autonomic function in hypertensive and normotensive subjects:the importance of gender.Hypertension,2001,37(6):1351-1356.
9Ellis JA,Wong ZY,Stebbing M,et al.Sex,genes and blood pressure.Clin Exp Pharmacol Physiol.2001,28(12):1053-1055.
10麦劲壮,饶栩栩,刘小清,吴勇,李河.广东省不同个体特征人群血压差别的调查分析[J].岭南心血管病杂志,2001,7(1):1-4. 被引量：6